Thoughts on Suicide, Living, and Dying

My mind has been in a million different places today. I read this thoughtful post by a doctor about a patient that committed suicide. I saw this today on dying with dignity:

I come at this from the perspective of a medical professional that has seen death and dying up close and personal for almost thirty years. I come at this from the place of a person with a history of persona trauma and loss. I come at this from the perspective of an atheist. I come at this from the perspective of someone that researches the deaths of trans people across the world for the Remembering our Dead/Transgender Day of Remembrance project. I come at this from having partners who struggle with mental illness. From each one of these perspectives, I see life and death up close. I often see conflicting messages when seeing the suffering, the pain, and the joy of living.

When I saw Brittney’s story and I read the doctor’s words about the suicide of a 50-year-old man with a history of depression, I saw a similar story. I saw a story of two people dealing with a life-threatening illness. I saw a story of two people taking control of their life, destiny, and pain.

I think about every person I’ve ever treated as a medical professional that was at their life’s end. So many times, what I end up seeing is suffering. Needless suffering. Terminally ill patients with families that just can’t let go of their loved ones. I’ve had to perform scans on those patients. Patients who cried during the procedures cried out that they just wanted to die. They are the patients who have feeding tubes. The patients who have lived years, sometimes a quarter of a century, living in a bed. I’ve gone home, just put my face in my hands, and cried because of those patients. From that perspective, I’m like close to 80% of doctors that would avoid chemotherapy for aggressive forms of cancer that have little hope of a cure. I understand the rational choice not to suffer needlessly and have control over your life up until the end of it. I’m an atheist, but the needless suffering I’ve seen has made me see it as a kind of “hell on earth.” I don’t want that for myself.

From my trauma, I can understand losing hope. 12 years ago, I lost the ability to see my daughter and be a part of her life because of who I am. For almost 6 years, I suffered from situational depression because of this. Most recently, I’m about 6 months out from ending a relationship. I mourn that.

Being visibly trans isn’t the easiest path in life, either. At times it weighs on my life like a heavy anchor. It limits my job choices, income, and many other aspects of my life. Parts of my trans life history have been so damaging, so brutal, and honestly… so unnecessary. When news broke of Kate von Roeder’s very public suicide, I commented at the time that I think anyone that’s visibly trans can understand why she took her own life. I looked at her letter and can honestly say that I understand why she did it. Some may say that makes me unstable or depressed, but I think of the words of comedian Marc Maron:

“If somebody comes up to you and says ‘you might be clinically depressed’, you should probably say ‘thank you! That means I’m awake.’ Is there any indication I shouldn’t be depressed? Are you living on the same planet as I am? Do you ever think that depression might be the reasonable human response to the crap we’re going through as a species?”

I’m not saying I want to kill myself. I’ve thought about it,  and every time I do it comes back to the same question:

“Do I want to relieve myself of pain, more than I want to live?”

The answer to that question has been a consistent no. As complex as life is right now and unsure of my future, I still find joy and wonder in life. I still want more. I still want to be here and see how this all plays out. Doing the TDoR list, I see (sometimes graphically so) trans women losing their life because they are trans. The pain I feel from my life experience is tempered with the knowledge that my privilege (class, race, geography) allows me not to feel as much pain as many others do.

I’m glad I’m here, and I’m glad I’m alive right now. Though my pain may last, I acknowledge that it will lessen over time. That there will be a day sometime in the future when I’ll yearn for today, for more time, for one more chance at living, but tomorrow won’t come. I’m hopeful I’ll have a choice of when and if enough is enough when the answer to the question above is that the pain is too much. Personal autonomy/agency is a gift that many people don’t receive.

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